Originales
Desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo
Socioeconomic inequalities in the provision and uptake of prenatal care
Gemma Cano-Serrala,
, Maica Rodríguez-Sanza, Carme Borrella, María del Mar Pérezb, Joaquín Salvadora
Autor para correspondencia
gcano@aspb.es
Correspondencia: Dra. Gemma Cano-Serral. Servicio de Sistemas de Información Sanitaria. Agència de Salut Pública de Barcelona. Pl. Lesseps, 1. 08023 Barcelona. España.
Correspondencia: Dra. Gemma Cano-Serral. Servicio de Sistemas de Información Sanitaria. Agència de Salut Pública de Barcelona. Pl. Lesseps, 1. 08023 Barcelona. España.
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España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Socioeconomic inequalities in the provision and uptake of prenatal care" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-12-01" "fechaAceptado" => "2005-08-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec14008" "palabras" => array:5 [ 0 => "Desigualdades socioeconómicas" 1 => "Salud maternoinfantil" 2 => "Cuidado médico del embarazo" 3 => "Control personal del embarazo" 4 => "Salud pública" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec14007" "palabras" => array:5 [ 0 => "Socioeconomic inequalities" 1 => "Maternal and child health" 2 => "Prenatal care" 3 => "Planned pregnancy" 4 => "Public health" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Describir las desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo de las gestantes de Barcelona durante 1994-2003.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Diseño transversal de las gestantes de Barcelona que tuvieron un hijo sin anomalías congénitas. La información se obtuvo de las historias hospitalarias y una encuesta realizada a las madres del Registro de Defectos Congénitos de Barcelona, que recoge una muestra aleatoria del 2% del total de nacimientos de esta ciudad (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.299). Se estudiaron las siguientes variables dependientes: visitas al obstetra, trimestre de la primera visita, número de ecografías, ecografía del quinto mes, realización de una prueba invasiva, consumir ácido fólico, planificación del embarazo, consumo y abandono del tabaco. Las variables independientes fueron la edad y la clase social. Se ajustaron modelos de regresión logística para cada variable dependiente.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Las gestantes de clases sociales con ocupaciones manuales realizan, en mayor proporción, menos de 6 visitas y la primera visita después del primer trimestre; además, tienen menor probabilidad de realizar alguna prueba invasiva, tomar ácido fólico, planificar el embarazo, no fumar y abandonar el consumo de tabaco. Y las gestantes de clases no manuales realizan, en mayor proporción, más de 12 visitas y más de 3 ecografías.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Hay desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo en Barcelona. Las gestantes de las clases sociales más favorecidas realizan un mejor cuidado y control del embarazo, pero en todas se observa una excesiva medicalización. Una racionalización del uso de recursos sanitarios y una reducción de la medicalización podría disminuir las desigualdades relacionadas con el cuidado y el control de la gestación en Barcelona.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To describe socioeconomic inequalities in the provision and uptake of prenatal care among women in Barcelona (Spain) between 1994 and 2003.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Cross-sectional study of women in Barcelona who delivered a child without birth defects. Information was obtained from hospital medical records and a personal interview with women included in the Barcelona Birth Defects Registry, containing a random sample of 2% of all pregnant women in the city (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2299). Dependent variables: number of obstetric visits, the trimester of the first visit, the number of obstetric ultrasound scans, the fifth-month diagnostic ultrasound scan, invasive procedures, prenatal folic acid intake, pregnancy planning, smoking and smoking cessation. The independent variables were maternal age and social class. Logistic regression models were filted for each dependent variable.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In social classes with manual occupations, there was a higher proportion of pregnant women who attended less than six obstetric visits and who attended the first obstetric visit after the first trimester. Moreover, these women were less likely to have undergone an invasive procedure, to have taken folic acid supplements, to have planned the pregnancy, to be non-smokers and to stop smoking. In the more privileged classes, there was a higher proportion of women who attended more than 12 obstetric visits and who underwent more than three ultrasound scans.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Socioeconomic inequalities were found in the provision and uptake of prenatal care in Barcelona. Uptake was greater in the more advantaged social classes but excessive medicalization was found in all classes. Rationalizing the use of healthcare resources and reducing excessive medicalization would reduce inequalities in prenatal care in Barcelona.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "L’evolució de les desigualtats en la salut a Catalunya. Fundació Jaume Bofill i CAPS (Centre d’Anàlisi i Programes Sanitaris)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Borrell" 1 => "J. 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Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13084124
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